8 ways to fall back asleep after waking in the night

CNN Chief Medical Correspondent Dr. Sanjay Gupta has the latest medical advice on how to use exercise for better sleep.

Posted: Feb 23, 2021 1:35 PM


It could be nature's call, the pitter-patter of little feet (No, honey, it's not daytime yet, go back to bed) or a squirrel scampering loudly across the roof over your bedroom -- and suddenly you are awake. Very awake.

Then before you know it, your mind is flooded with things you forgot to do, worries over finances or reliving an unpleasant experience you planned to forget. Sleep is a lost cause -- or is it?

Here are eight tips from sleep and anxiety experts on how to shut down that whirling dervish of a brain and coax your body back into much-needed sleep.

1. Use deep breathing

Deep breathing is a well-known method of stress reduction and relaxation, if done correctly.

Start by putting your hand on your stomach. Close your eyes and take a slow, deep breath through your nose, making sure that you can feel your abdomen rise. Try to breathe in for a slow count of six. Now release that breath very slowly -- to the same count of six -- through your mouth.

"Taking slow deep breaths, in through the nose and out through the mouth using our main respiratory muscle, the diaphragm can help relax the body and mind," said sleep specialist Dr. Raj Dasgupta, an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California.

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2. Try guided sleep meditations and muscle relaxation

Meditation, of course, is a great way to calm the mind. But if you're not a practiced meditator, the act of trying to keep your mind focused might become a source of stress.

You could try a guided sleep app, "some of which actually embed delta sleep waves," said stress management expert Dr. Cynthia Ackrill, an editor for Contentment magazine, produced by the American Institute of Stress.

"Put it on loop so you don't wake up," Ackrill said. "Lie there and listen and slow your breathing down. Keep focused on their guidance or if you are just listening to a music/white noise, focus on your breath. Your mind will interrupt — don't judge it, but keep coming back to your breath."

If your body is still tense, try adding progressive muscle relaxation to your breathing. Starting with your toes, breath in and tense the muscles in that area, holding the tension for up to 10 seconds. Release the tension quickly, all at once, and imagine breathing through that part of the body as you exhale. Move from your toes to your feet, calves, upper thighs and the rest of the muscle groups in the body.

3. Stop the blame game

There is a whole channel in your brain dedicated to judging your inability to sleep, and it loves to play the "blame and shame" game, said Ackrill, a former family physician who is also trained in neuroscience, wellness and leadership coaching.

"If you have had the issue for any length of time, you have probably researched or discovered that not sleeping is not good for you. So besides your brain turning on about whatever worries are front and center, you also start repeatedly worrying about the effects of lack of sleep. And as with most worries, you probably judge yourself for it," Ackrill said.

"Throw yourself a little compassion," she advised. "It's not a reflection of your worth."

Then, to prevent the mind from revving up at night, give your brain a break a few times during the workday: "If your brain has been in high gear all day, it has a harder time shutting down. Bring it back to neutral at least a couple of times a day with 5-minute breaks of breath work," said Ackrill.

4. Avoid clock watching

Want to feel even more anxious and guilty about not sleeping? That's what clock watching will do. So don't keep checking the time -- really.

"It's important not to get worked up about one bad night's sleep because anxiety itself makes it difficult to fall back asleep," said USC's Dasgupta.

It can also be overstimulating, said Dr. Bhanu Kolla, an addiction psychiatrist and sleep medicine expert at the Mayo Clinic.

"You usually end up trying to determine how much time you have left to sleep and worrying about whether you will fall back to sleep in a reasonable amount of time," Kolla said. "This can in fact make the process of returning to sleep more difficult."

Don't grab a sneak peak when you go back to bed, either. Seeing the time may only rev you up again.

5. Don't drink alcohol before bed

Don't drink before bed, said Kolla, who studies the interaction between sleep disturbances and addictive disorders.

"As alcohol is metabolized it forms acetaldehyde which is stimulating," he told CNN. "Therefore if you drink too much alcohol right before going to bed, in about four hours it is converted to aldehyde which can disrupt sleep and wake you up."

In addition to awakenings during the night, alcohol can cause "frequent trips to the bathroom because it inhibits a hormone called anti-diuretic hormone (ADH), resulting in increased urination," Dasgupta added.

6. Write down your worries

It's best to try to get rid of your worries -- as much as possible -- well before bed, experts say.

"Close the day by capturing anything left to do tomorrow -- so you don't have to work on that at 3 am -- and bullet point ongoing issues so you have a clear picture," Ackrill said. "Reflect on what went well (that day) and be grateful. This is good to do at end of work day or after dinner, before evening relaxation."

However, it you missed that step or your brain still doesn't want to let go despite the use of relaxation techniques, try "dumping" as a method of stress reduction, Ackrill said.

"Keep a pad and low light next to the bed and write the list down," she said. "If that doesn't work -- your mind is really on -- get up. Leave the bedroom and do a quick writing dump of worries, thoughts and ideas. If you are really upset, write to exhaustion."

7. Beware of blue light and stimulation

Don't use a computer, smartphone or tablet to jot down your worries, though, experts warn.

In fact, the No. 1 rule is "no computers, cell phones, and PDAs in bed and at least one hour prior to bed time," said Dr. Vsevolod Polotsky, who directs sleep basic research in the division of pulmonary and critical care medicine at Johns Hopkins University School of Medicine.

Instead, write your to-do or worry list on paper, using only a dim light, he advised. And if you decide to read to put yourself to sleep, make sure you read in a dim light off from a real book, not a tablet or an e-reader.

That's because "any LED spectrum light source may further suppress melatonin levels," Polotsky said. Melatonin, secreted in a daily 24-hour circadian rhythm, is often referred to as a "sleep hormone," because we sleep better during the night when levels peak.

"Digital light will suppress the circadian drive," Polotsky said, while a "dim reading light will not."

Oh, and one more thing, Polotsky said: "Grab the most boring paper book you can find," because you don't want to read or do anything stimulating when you are trying to fall back asleep.

Surprise! That includes taking a warm shower or bath, he added. Why ever not?

"Because it is a significant activity, which may further disrupt sleep," Polotsky said. "By the same token, I had some patients going for a short stroll in the middle of the night or doing dishes -- no to both."

8. Get up after 20 minutes

Don't just lie there staring at the ceiling, experts say. If you can't get back to sleep after 15 or 20 minutes, get out of bed and go into another room where there is dim light and do something calming until you feel drowsy again.

(Note: We have already learned that dishes, strolls and warm baths are not calming.)

"Maybe read a boring book and try a little Sudoko, but avoid picking up that cell phone or going on your computer," Dasgupta said. In addition to blue light, "the temptation to go on social media or check your work e-mails might prevecnt your mind from relaxing," he said.

Do those boring activities until you start feeling drowsy, and "only then return to bed," Mayo's Kolla said. "If you do not fall asleep in another 10 minutes, again get out of bed and do the same thing. The idea is to avoid long times in bed where you are not sleeping."

Why is lying in bed a problem?

"We do not want what we call 'dead time' in bed, time where you are in bed trying to fall asleep but not sleeping," Kolla explained. "This tends to cause some frustration and anxiety.

"In addition we want the bed to be a place that you associate with sleep," Kolla added. "The more you do other things including lay awake trying to fall asleep, the weaker this association gets and the more difficult it is to fall back asleep."

That's one of the reasons that all sleep experts advise against using a laptop or tablet in bed, watching television from your bed, or frankly not much of anything except ...

"Bed is only for sleep and sexual activity, nothing else!" Polotsky said.

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